BLEEDING     

 

    BLEEDING

    The principle of controlling blood loss is to restrict the flow of blood to the injured part by pressure and elevation, without stopping basic requirements of the body.

    SOME BLEEDING IS OK

    The act of bleeding actually helps clean out the wound. Of course, too much bleeding will cause the patient to lose ability to reason and then eventually to function altogether. Puncture wounds, for instance, pose another set of problems, as contaminants are probably inside of the wound, unable to naturally get out.

    LARGE BLEEDING

    If there is large bleeding (amounts large enough to start filling a glass), then there is concern for loss of life. The greatest worry is loss of blood. Take fresh paper towels or a fresh clean towel and wrap the wound tight enough to almost stop the bleeding. If the wound is on the head or midsection, hold over the wound, or if the wound is larger, put into the wound. It is not necessary to completely stop the bleeding, only to slow it up severely.

    Apply DIRECT PRESSURE on the wound. use a dressing, if available. if a dressing is not available, use a rag, towel, piece of clothing or your hand alone.

    IMPORTANT: ONCE PRESSURE IS APPLIED, KEEP IT IN PLACE. IF DRESSINGS BECOME SOAKED WITH BLOOD, APPLY NEW DRESSINGS OVER THE OLD DRESSINGS. THE LESS A BLEEDING WOUND IS DISTURBED, THE EASIER IT WILL BE TO STOP THE BLEEDING!

    If bleeding continues, and you do not suspect a fracture, ELEVATE the wound above the level of the heart and continue to apply direct pressure.

    If the bleeding still cannot be controlled, the next step is to apply PRESSURE AT A PRESSURE POINT. For wounds of the arms or hands, pressure points are located on the inside of the wrist ( radial artery-where a pulse is checked) or on the inside of the upper arm (brachial artery). For wounds of the legs, the pressure point is at the crease in the groin (femoral artery). Steps 1 and 2 should be continued with use of the pressure points.

    The final step to control bleeding is to apply a PRESSURE BANDAGE over the wound. Note the distinction between a dressing and a bandage. A dressing may be a gauze square applied directly to a wound, while a bandage, such as roll gauze, is used to hold a dressing in place. Pressure should be used in applying the bandage. After the bandage is in place, it is important to check the pulse to make sure circulation is not interrupted. When faced with the need to control major bleeding, it is not important that the dressings you will use are sterile! use whatever you have at hand and work fast!

    SMALL BLEEDING

    Bleeding is not much of a problem, only the proper care such as cleaning and perhaps, shots, and stiches can be prepared by medical professionals. Some time should be spent cleaning the wound, since there is little concern of serious blood loss.

    INTERNAL BLEEDING

    Many times, bleeding from auto accidents or falls will result in internal bleeding. There is little that can be done to stop this kind of bleeding. Keep the patient as calm as possible, with very little movement, and resting on their side or stomach. If they are resting on their back, watch for choking and breathing problems.

    Signs and symptoms of INTERNAL BLEEDING are:

  • bruised, swollen, tender or rigid abdomen
  • bruises on chest or signs of fractured ribs
  • blood in vomit
  • wounds that have penetrated the chest or abdomen
  • bleeding from the rectum or vagina
  • abnormal pulse and difficulty breathing
  • cool, moist skin

    First aid in the field for internal bleeding is limited. If the injury appears to be a simple bruise, apply cold packs to slow bleeding, relieve pain and reduce swelling. If you suspect more severe internal bleeding, carefully monitor the patient and be prepared to administer CPR if required (and you are trained to do so). You should also reassure the victim, control external bleeding, care for shock (covered in next section), loosen tight-fitting clothing and place victim on side so fluids can drain from the mouth.

    OBJECTS IN THE WOUND

    If there is a foreign body in the wound, such as glass, apply pressure alongside. If you are sure there is no fracture or dislocation, raise the part and support it while maintaining pressure. This should decrease the flow of blood. If bleeding continues, apply indirect pressure. Press the artery at the next pressure point (pressure points are difficult and sometimes dangerous to use, and should only be used by someone trained in first aid). Cover and dress the wound as soon as possible. Send for medical assistance.

    IF SOMETHING IS CUT OFF

    Wrap any severed part, (such as a finger) in a bag and place it in ice if possible, and send with casualty (Don't place the finger in direct contact with the ice).

    CLEANING THE WOUND

    If there is large bleeding, there is little gained from attempts to clean the wound, and it could do more harm than good. For smaller wounds or punctures, run clean water over the cut or wound, then disinfectant, iodine, or alcohol poured directly on the wound is best. Contaminated clothing should be removed. Mild to moderate bleeding cuts and scrapes usually stop bleeding if washed and dressed firmly. A course of tetanus injections may be necessary.

    DRESSING THE WOUND

    Apply a clean dressing to the wound with firm, constant pressure, which is adequate for up to twenty minutes.